The vision of our proposal to continue as a center of excellence in cancer communication research is to reduce the burden of cancer for those who suffer unnecessarily for lack of support or information. Our center (a partnership between the Universities of Wisconsin and North Carolina, the National Black Leadership Initiative on Cancer - Midwest, Kaiser Permanente Northwest, and M D Anderson) will include three randomized control trials (Effectiveness, Prolonging Life and Survivorship) and a set of development projects intended to affect Reach: We will: (a) serve low literacy populations with audio and video rather than text, (b) expand ranges of patients served from pre-diagnosis through dignified death or optimal survival, and (c) move ICCS research into colon cancer and activity enhancement. Efficacy and Effectiveness: We will (a) test whether CHESS has the same results in the "effectiveness" context as found in the efficacy context, (b) improve outcomes by testing the efficacy of small devices rather than laptop computers and by enhancing CHESS collaborative nature by using wikis and other co-creation technologies, and (c) further understanding of communication science via Self Determination Theory, and examine the impact of ICCS beyond psychosocial outcomes to new behavioral and clinical outcomes. Adoption, Implementation and Maintenance: We will (a) examine acceptance and feasibility of using ICCS in a large HMO, test the representativeness of the adopters of ICCS and the extent to which implementation follows intent, and (b) gather data on how the ICCS can be fully integrated into the organization to build the business and clinical cases for adoption. The projects will translate research into real world applications, advance the technology of ICCS and knowledge of outcomes and mechanisms of effect;it will also enhance the theory base around which such systems can be developed and tested. This proposal responds to the National Cancer Institute's call for systems that improve personalized patient and family support, address survivorship needs, have real world dissemination, enable efficient healthcare utilization, and improve QOL across the cancer continuum.